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Updated: Dec 31, 2025

Predicting the Effectiveness of Population Replacement Strategy Using Mathematical Modeling
Published on: July 4, 2007
Development and evaluation of a prospective staffing model to improve retention
Kelly Marie Kester1, Mary Lindsay2, Bradi Granger3
1Nurse Manager Cardiothoracic Intensive Care Unit, Duke University Hospital Durham, Durham, NC, USA.
Aims:
To improve predictability and accuracy of hiring using historical staffing data, quality improvement and workforce engagement.
Background:
Twenty-three per cent of newly licensed nurses leave their first job within one year, costing employers $52,100 per nurse replacement. Tools for anticipatory hiring strategies are not available in the literature.
Methods:
We used retrospective, secondary data analysis to develop a Prospective Staffing Model and conduct a five-year longitudinal evaluation of the implementation of the model in a convenience sample at a quaternary academic Cardiothoracic Intensive Care Unit. We used a team-based, quality improvement approach to restructure recruitment and hiring strategies, standardize new graduate nurse orientation and implement AACN Healthy Work Environment standards.
Results:
Over the five-year prospective evaluation period (2014-2018), 388 nurses were hired and included in the evaluation cohort. Retention increased (n = 286 days) and turnover decreased (17.6%) between 2014 and 2018. Improvements in workforce stability were sustained at five years.
Conclusions:
Use of a Prospective Staffing Model is associated with improved nurse retention and decreased turnover, and may improve workforce stability.
Implications For Nursing Management:
Results suggest that an innovative tool can mitigate the deleterious effects of turnover, adding to current knowledge and providing a method for anticipatory assessment of local turnover.
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